Exposure-Based Treatment for Anxiety Disorders

Has anxiety taken over your life?

You're not weak—you're stuck in a cycle that avoidance keeps feeding

Maybe it started small. A little worry about social situations, or some nervousness about specific things. But now anxiety runs your life. You plan everything around avoiding what makes you anxious. You turn down invitations, miss opportunities, and watch your world get smaller and smaller. The things you used to do easily now feel impossible.

You tell yourself you'll face your fears when you feel ready, when your anxiety gets better, when you feel braver. But that day never comes. Instead, the anxiety gets worse. The list of things you avoid keeps growing. And the more you avoid, the more powerful your anxiety becomes.

What started as protection has become a prison. You're exhausted from constant worry, from saying no to life, from feeling controlled by fear that you know—logically—doesn't make sense. But knowing your anxiety is irrational doesn't make it go away.

Are you avoiding situations that trigger your anxiety?

You may have become an expert at avoidance. You might avoid social situations because you're terrified of being judged, embarrassed, or saying something stupid. You might avoid driving on highways, flying, or going places where you can't easily escape. Maybe you avoid crowded spaces, elevators, bridges, or anywhere that triggers panic.

Or perhaps you avoid anything contaminated—you wash your hands dozens of times a day, refuse to touch certain surfaces, or can't eat food others have prepared. Maybe you avoid leaving your house, making phone calls, going to stores, or doing anything that isn't part of your carefully controlled routine.

The avoidance might be obvious—physically staying away from feared situations. Or it might be subtle—going to events but staying near the exit, attending meetings but never speaking up, going to restaurants but only ordering safe foods. Avoidance can become automatic and habitual, and we may stop being aware of the fact that it is avoidance.

Your world has shrunk. You've lost opportunities, relationships, and experiences because anxiety dictates what you can and cannot do. You know you're missing out on life, but facing your fears feels impossible. The anxiety is too intense, too overwhelming, too unbearable.

Do you spend excessive time worrying or performing rituals?

Maybe your anxiety doesn't just make you avoid things—it forces you into exhausting patterns you can't break. You might spend hours each day worrying about terrible things that could happen, playing out worst-case scenarios in your mind until you're paralyzed with fear.

Perhaps you have intrusive thoughts that horrify you—thoughts about harm, contamination, making mistakes, or things going terribly wrong. These thoughts feel dangerous, and you do whatever you can to neutralize them. You might have to perform rituals: checking the locks repeatedly, washing in a specific order, counting, arranging things perfectly, or seeking reassurance from others over and over.

Or maybe you need constant certainty. You ask "what if" questions endlessly, research symptoms online for hours, seek reassurance that everything will be okay, or need to know exactly what will happen before you can do anything. The uncertainty feels intolerable, and you'll do anything to make it go away—but the relief never lasts.

These patterns take hours out of your day. They exhaust you. They interfere with work, relationships, and basic functioning. You know they're excessive, but you can't stop. The anxiety that comes when you try to resist is too overwhelming, so you keep doing what anxiety demands.

Does anxiety control what you can and cannot do?

Anxiety makes decisions for you now. It tells you where you can go, what you can touch, who you can be around, what you can try. It whispers that danger is everywhere, that terrible things will happen, that you can't handle discomfort or uncertainty.

Maybe you've turned down job opportunities because they involved public speaking or travel. Maybe you've ended relationships or never started them because intimacy triggers anxiety. Maybe you've dropped out of school, quit activities you loved, or stopped pursuing goals because anxiety said no.

You might have panic attacks that feel like you're dying—heart racing, can't breathe, dizzy, terrified you're having a heart attack or losing your mind. So you avoid anything that might trigger panic, which becomes more and more things over time.

Or maybe you have specific phobias that seem ridiculous to others but are completely debilitating to you. Heights, insects, blood, needles, vomit, storms, animals—whatever it is, the fear is so intense that you organize your entire life around avoiding it.

You're tired of anxiety being in charge. You're tired of saying no to life because of fear. You want to break free, but you don't know how to face what terrifies you.

How exposure therapy helps you overcome anxiety

Exposure therapy is based on a powerful principle: avoidance maintains fear, and facing your fears reduces them. When you avoid what makes you anxious, you never learn that you can handle it, that the feared outcome doesn't happen, or that anxiety decreases on its own if you stay in the situation long enough.

When you're ready to get started, we'll work collaboratively to create a personalized plan that gradually exposes you to feared situations while teaching you that you're safe, that you can tolerate discomfort, and that anxiety doesn't have to control your choices. Treatment is structured but flexible, moving at a pace that challenges you without overwhelming you.

How the treatment process works

We start by understanding your specific anxiety and creating your fear hierarchy. Together, we'll identify all the situations, objects, thoughts, or sensations you avoid or that trigger anxiety. We'll rate each one on a scale of 0-100 based on how much distress it causes. This creates your fear hierarchy—a roadmap from less anxiety-provoking items to more challenging ones. This isn't about throwing you into your worst fear immediately; it's about creating a gradual, systematic path to freedom.

Next, we teach you how exposure works and why avoidance keeps you stuck. You'll learn about how anxiety functions, why it feels so intense but isn't actually dangerous, and how your brain can learn new associations through repeated exposure. Understanding that anxiety is uncomfortable but not harmful, and that it naturally decreases if you stay in feared situations, helps you commit to the work ahead. We'll also teach you techniques to stay grounded and manage physical anxiety symptoms without relying on avoidance or safety behaviors.

Then we begin systematic exposure, starting with moderately challenging items. We don't start with your most feared situation—we start with something that causes moderate anxiety. This might mean sitting in a crowded room, touching a doorknob without washing your hands, or making a phone call you've been avoiding. The key is staying with the exposure long enough for your brain to learn that the feared outcome doesn't happen and that you can handle the discomfort.

We gradually work up your hierarchy, eliminating safety behaviors. As lower-level exposures become easier, we move to more challenging situations. Crucially, we also eliminate safety behaviors—those subtle things you do to feel safer but that actually maintain anxiety. This might mean going to social events without pre-planning what to say, driving without constantly checking mirrors, or touching "contaminated" objects without immediately washing. These safety behaviors prevent you from fully learning that you're safe, so we systematically remove them as you progress.

We practice exposures repeatedly, in various contexts, until anxiety no longer controls you. Repetition is essential. You'll practice exposures during sessions and as homework between sessions. You'll face feared situations in different locations, at different times, with different people. The more you practice, the more your brain learns the new lesson: this isn't dangerous, I can handle this, and anxiety doesn't have to dictate my choices. Over time, situations that once paralyzed you become manageable, then easy, then boring. That's when you know you've won.

Why choose exposure therapy at our clinic?

We make exposure manageable, not traumatizing. Many people fear that exposure therapy means being forced into terrifying situations before they're ready. That's not how we work. Exposure is gradual, systematic, and collaborative. You're involved in every decision about what to face and when. We push you outside your comfort zone—that's necessary for change—but we don't push you beyond what you can handle. Our therapists are skilled at finding the right balance between challenging you and keeping you engaged in treatment.

We have proven results with lasting change. Exposure therapy has decades of research showing it's the most effective treatment for anxiety disorders. Studies consistently show that 60-90% of people who complete exposure therapy experience significant, lasting improvement. Unlike medication alone, which only works while you take it, exposure therapy teaches your brain new patterns that persist long after treatment ends.

We individualize your treatment. When needed, we can use exposure therapy within the framework of Dialectical Behavior Therapy (DBT), so that you can build skills to regulate emotions and tolerate distress before, during, and after exposure. If you don’t need DBT and you’re ready to jump right into working on anxiety concerns, we’re happy to help with that too. We can treat teens (13 and up) and adults and we always tailor the treatment to the individual’s needs and goals.